摘要
目的 探讨沙利度胺与地塞米松联合治疗多发性骨髓瘤（MM）的临床疗效及不良反应。方法 39例初治MM患者，随机分为两组，VAD方案对照组：长春新碱加阿霉素加地塞米松；治疗组：沙利度胺加地塞米松，沙利度胺起始剂量为100～200mg/d，以后每周加量50～100mg／d，最大剂量400mg/d，并加用地塞米松20mg（m^2．d），第1～4天，第9～12天，第17～20天，30天后重复上述方案，至少治疗3个月。结果治疗组部分缓解9例（45．0％），进步6例（30．0％），无效5例，总有效率75．0％（15／20），明显优于对照组（总有效率52．6％）（P〈0．05）；能有效降低M蛋白，使骨髓瘤细胞下降，提高血红蛋白和改善生活自理状况（P〈0．05）。副反应程度均可耐受。结论 沙利度胺联合地塞米松治疗多发性骨髓瘤（MM）具有副作用少、耐受性好、给药方便、费用低、疗效明显的优点，值得临床推广应用。
Objective To study the curative effect and side effect of thalidomide incorporation with dexamethasone in treatment of multiple myeloma. Method 51 multiple myeloma patients were randomly divided into VAD group, dexarnethasone plus thalidomide respectively, the beginning dose of thalidomide was 100 - 200mg/d, increase 50～100 mg/d every week till 400 nag/d; dexamethasone 20 mg/（m^2. d）, dl - 4. d9 - 12. d17 - 20, try it again every 30 days, maitain for at least three months. Result The experimental group had 9 partial relief cases （ 45.0 % ）, 6 improved cases （30.0 % ）,5 inefficacy cases （25.0 % ）, total efficacy rate was 75.0 % （ 15/20 ）, significantly higher than that in control group（with total efficacy rate 52.6%（（P 〈 0.05） ;the experimental schema effectively brought down the M protein and the number of myeloma cells, raised hemoglobin level and improved the ability of self attendance （P 〈 0.05 ） ; while the side effects were tolerable. Conclusion Thalidomide incorporation with dexamethasone applied in multiple myloma has merit such as less side effects, good tolerance, convenient administration, less cost and significant curative effect, it would be valuable to do clinical research and widespread popularization.
出处
《南华大学学报（医学版）》
2007年第2期207-209,213,共4页
Journal of Nanhua University(Medical Edition)
